Direct funding of health facilities: findings from an evaluation of the Health Sector Services Fund in Kenya

July 2014
Evelyn Waweru, Sassy Molyneux, Catherine Goodman, Benjamin Tsofa

The Health Sector Services Fund (HSSF) is an innovative scheme that provides funds directly to primary health facilities. It was established in 2010 by the Government of Kenya with the aim of increasing resources at peripheral health facilities to provide adequate services, and encouraging community involvement in the identification of health priorities and appropriate solutions.

Researchers from KEMRI-Wellcome Trust Research Programme and the London School of Hygiene & Tropical Medicine have been evaluating the HSSF and will continue tracking its implementation and impact in several counties until 2016. During this time, the Kenyan health system will be devolved to the county level, offering a huge opportunity for more responsive and accountable services, but also new challenges for HSSF’s design and implementation.

This research brief presents the key findings from a mixed-methodology interim evaluation of HSSF and its implementation until May 2013. It identifies impressive achievements in terms of ensuring that funds reach facilities, are spent appropriately, and are overseen and used in a way that strengthens community involvement. The evaluation also highlights obstacles to effective implementation and important issues for consideration in future HSSF planning in light of the devolved health system, and in other financing mechanisms for peripheral facilities in Kenya and beyond. 

Governance Kenya Accountability